Daily Archives: April 21, 2010

Oral Medication May be more Effective than Topical for Killing Head Lice

In a column I wrote for physicians nearly a decade ago, I discussed the growing use of oral medications, like ivermectin, for some topical skin infections. Now, a study published in the New England Journal of Medicine has found that in tough cases of head lice, Stromectol (ivermectin), which is “not approved for use in the US for head lice,” eradicates the “parasites more effectively than” a lotion containing the insecticide malathion.

According to a report in The Los Angeles Times, the researchers studied “812 people in 376 households in seven areas in the world,” and found that in the “ivermectin group, 95% of the participants were lice-free after two weeks, compared with 85% of the malathion group.” The Times adds, “Ivermectin is not approved for use in the US for head lice.”

Bloomberg News points out that “those in the medical trial were considered hard to cure because they had been treated unsuccessfully with lotions for their head lice for two to six weeks before the start of the study.”

The researchers also “said the medicine should be restricted to people whose head lice doesn’t go away with other treatments to prevent resistance to the drug.”

Resistant Ringworm Common in Some Elementary Schools

Treatment-resistant ringworm is common among urban elementary school children — at least according to a new report from U.S. researchers. They studied 10,514 children in kindergarten through Grade 5 at 44 schools across the bi-state Kansas City metropolitan area, and found that 6.6 percent of them were infected with the fungus (T. tonsurans) that causes ringworm, which can cause scaly, itchy scalps and hair loss. Here are the details from a HealthDay article:

Infection rates varied by age and race. More than 18 percent of black children in kindergarten and the first grade were infected. That rate dropped to 7 percent by fifth grade. Infection rates were 1.6 percent for Hispanic children and 1.1 percent for white children. The reasons for the higher rate among black children aren’t clear. The study is published in Pediatrics.

“The organism T. tonsurans has become the leading cause of scalp infection in the U.S., and we believe it is on the rise in inner city areas,” study author Susan Abdel-Rahman, a professor of pediatrics and pharmacy at Children’s Mercy Hospitals and Clinics, said in a news release.

“This study supports what I and many of my peers are seeing, children with scaly, itchy scalps and hair loss are prevalent in metropolitan areas. If not treated, ringworm can lead to permanent hair loss, which can damage a child’s self-image. There is also some evidence that it may worsen seemingly unrelated problems such as asthma and allergic rhinitis.”

The oral antifungal medicine used to treat ringworm does not completely eliminate the fungus in many children, which means they can spread the infection to others even after treatment.

T. tonsurans has learned how to stay on the host and avoid eradication. This can be very frustrating for children who keep getting re-infected and for their parents who are doing everything they can to prevent this,” Abdel-Rahman said.

“We have only recently started to appreciate just how many children carry this pathogen so we don’t yet know the best way to tackle this problem. However, I do advise parents to limit the sharing of items that come into contact with the scalp, such as hats, combs, brushes and pillows.

“Watch closely for signs of infection, such as flaking that looks like dandruff, white patchy scaling, itching, hair thinning or loss, and small pus-filled bumps, especially when your child has come in contact with another infected child. Make an appointment to see your doctor if you suspect that your child is infected and make sure to take the prescribed medicine as directed along with the application of a medicated shampoo two to three times a week.”

The Nemours Foundation has more information about ringworm and related infections.

Stricter government oversight of dietary supplements may be moving closer – thank goodness

Whenever I give talks on natural medications (herbs, vitamins, and supplements), whether to healthcare professionals or laypersons, people seem shocked to learn that these substances are virtually unregulated in the United States. I’ve written about the many problems this causes healthcare professionals and consumers in my book, Alternative Medicine: The options, the claims, the evidence, how to choose wisely. So, I was very happy to read an AP article reporting “Stricter government oversight of dietary supplements is moving closer, thanks to an agreement among senators to include guidelines in” the Dietary Supplement Safety Act.

The report says that in a letter sent to Sen. Tom Harkin (D-IA), chairman of the Senate Health, Education, Labor and Pensions Committee, Sens. John McCain (R-AZ) and Byron Dorgan (D-ND) outlined “four key areas of ‘common ground,'” two of which include “requiring all dietary supplement manufacturing, processing, and holding facilities to register with the Secretary of Health and Human Services,” and “giving the Food and Drug Administration authority to issue a mandatory recall order if a dietary supplement is adulterated or misbranded.”

I hope they are successful. If so, it will go a long way toward protecting consumers from the deceptive practices and advertising used by some manufacturers or natural medications.